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Guidelines For Treating Depression
There are a variety of guidelines for treating depression published by the APA, CANMAT, BAP, NICE, and Texas Medication Algorithm Project. In general, they recommend exercise, psychotherapy and antidepressant medications.
The guidelines suggest that patients who don't respond to monotherapy, use CBT or SGA prior to starting medication and increase dosages if needed. Patients who are not responding to monotherapy could benefit from augmentation using lithium, psychostimulants or SSRIs.
1. Diagnosis
A diagnosis is the first step in treating depression. This involves a discussion with your physician or a mental health professional and some kinds of psychotherapy (talk therapy).
Your GP will ask you about your symptoms and how they have affected your life over the past month. They'll also inquire whether you've had any thoughts of self-harm or suicide. Your GP might also look at your general health lifestyle, family background and personal history when determining whether you have depression.
You must be honest and open with your doctor, so they get a full picture of how you are feeling. This will help them identify the signs of depression. These symptoms can be used to rule out other illnesses like cancer or heart disease.
Once your GP has determined that you may have depression and they'll rule out any other ailments through tests. For instance blood tests can look for anemia or thyroid problems that might be causing your depression. They can also test your blood for vitamin deficiencies, or even drugs and alcohol that can mimic depression.
If your GP determines that you suffer from depression, they'll explain the reasons behind it and the best method to treat it. This could include psychotherapy, or a combination of therapy and medication. Antidepressants are the most effective medication to treat depression. They work by changing the balance of chemicals in the brain. They can be taken either orally or by injection, and it may take a few weeks for them to start working. They can also cause adverse effects, such as dry mouth and constipation.
2. Medication
Many people can benefit from medication. suffering from depression. Your doctor may initially prescribe one or more antidepressants. If your initial treatment isn't producing a satisfactory response Your doctor may suggest that you try another medication or alter the dose or time of day that you take it. To get the most benefit of your medication, it is essential to take it regularly. Don't stop taking your medication without your doctor's permission.
Based on your symptoms, a general antidepressant may be prescribed or an SSRI. An SSRI is an antidepressant that raises the levels of the chemical serotonin within the brain. Examples of SSRIs include citalopram (Celexa) and escitalopram (Lexapro) and fluoxetine (Prozac). Your doctor might also prescribe a serotonin-norepinephrine reuptake inhibitor, or SNRI. SNRIs include duloxetine (Cymbalta) and venlafaxine (Effexor XR or Khedezla).
Other antidepressants, such as tetracyclics can be prescribed if a doctor thinks that these medications would be more efficient than an SSRI or SNRI. SSRIs and SNRIs are generally considered safe for use in children and adolescents.
It is important to inform your doctor if you have any allergies or health issues prior to taking any treatment. Some medications can result in side effects like an dry mouth or stomach that is upset. Generally, these are mild and will go away by themselves in a week or two. Avoid driving or operating machinery if you are taking medication.
The use of alcohol and other recreational drugs can exacerbate depression symptoms, such as insomnia or restlessness. These substances should be avoided as they can make depression harder to manage. If you continue to use them, especially for an extended period of time, may lead to more serious problems.
3. Psychotherapy
Psychotherapy (also called talk therapy) can assist you in dealing with issues that contribute to depression. This kind of treatment is long-term but has been shown to be effective in treating depression. Psychotherapy can be carried out in many different settings, like private therapists' clinics, hospitals, offices for rehabilitation and psychiatry facilities. It is usually one-on-one, but it is also possible to do group therapy.
Your therapy therapist will discuss your thoughts, feelings and behaviors as well as your relationships with you in a private and secure environment. In the initial few sessions your therapist will get to know you and suggest a treatment plan. depression therapy may include medication, psychotherapy, exercises and other treatments like repetitive transcranial magnetic stimulation (rTMS) or electroconvulsive therapy (ECT).
Some are short-term, and they focus on specific issues. Interpersonal therapy (IPT), for example helps people to understand the root of issues like unresolved grievances or conflicts with others. Depression can be caused by a range of factors including loss and stress to unresolved traumas, abuse and other issues. They may require more intense therapy or other treatments.
Cognitive behavioral therapy (CBT) is also referred to as cognitive restructuring, aids people change their thinking patterns that cause symptoms. It also improves coping skills and helps them deal with the stresses and challenges of daily life. Dialectical behavior therapy (DBT) incorporates elements of CBT with mindfulness techniques which allow you to be aware and accept your emotions.
Psychotherapy can often help with acute, moderate or severe depression as effectively as antidepressants do. However, it may take longer to work, and not everyone responds to it in the same way. It is essential to be present at your therapy sessions and to complete your homework in between sessions (like journaling or contemplating).
4. Counseling
If your symptoms of depression are severe or mild it is important to seek treatments that help. This could include psychological therapy or counseling. A professional outside can change your life. It could take a number of counselors to find the one who clicks with you. But it is worth the effort.
There are many types of psychotherapy. However the majority of them involve talking about your issues and developing strategies to manage depression. It can also be beneficial to share your experiences with other people who are going through similar issues. Group counseling is offered at medical clinics, hospitals or therapists' offices and even on your phone via online Telehealth services.
Counseling for depression is designed to reduce negative thoughts and behavior patterns that cause depression. For instance, a therapist might coach you on ways to manage stress to improve your mood. You might be taught to recognize irrational thoughts and challenge the preconceived notions that make you feel depressed. You could try EMDR (eye movement desensitization and processing) to relieve painful or traumatic memories that may contribute to depression.
Other treatments, like cognitive behavioral therapy or behavioural activation therapy, are used to assist you in identifying and alter your behavior patterns. For example the behavioural activation therapy is beneficial when depression causes you to avoid social activities. The goal is to encourage more social interaction and to identify the ways in which your actions impact your mood. Generally, these methods are employed in conjunction with medication. Ask your doctor for a referral or contact a local mental health center in your community to find a licensed therapist.
5. Exercise
Exercise is a proven method to reduce and treat depression. It's not a typical treatment. Psychotherapy and medication are more commonly used. Research that is growing suggests exercise is as effective as antidepressants and talking treatments for treating depression.
A meta-analysis of more than 150 studies found that it was more efficient than drugs or psychotherapy by themselves. The research found that, on average those with depression who exercised improved their symptoms by five points using one measure and 6.5 points with another which is clinically significant. The results were the same regardless of whether they exercised for a few minutes or an hour per day.
Exercise can also be an effective alternative to medication or psychotherapy, which might not be suitable for everyone. It also has the added benefit of keeping us physically healthy and preventing other mental health problems, including anxiety.
Furthermore exercising doesn't come with the stigma that can be associated with using drugs or going to talk therapy. It's open to everyone, has no costs attached and can be an extremely empowering method.
It's difficult to study exercise as a medicine because it is difficult for researchers to control factors like how often people exercise regularly and any other medications that they might be taking. Therefore, more research is needed to determine the best amount, frequency, and duration of exercise for preventing and treating depression. To aid patients suffering from depression, doctors are prescribing exercise as a part of their treatment plans. This is known as a "green prescription' and it involves writing an exercise plan that is based on the needs of the patient and encouraging them to be active by maintaining regular face-to-face or phone calls with a certified fitness professional such as an physical therapist or exercise physiotherapist.